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Takahiro Yokose, Masashi Takeuchi, Hideaki Obara, Masahiro Shinoda, Hirofumi Kawakubo, Minoru Kitago , Hiroshi Yagi, Yuta Abe, Yohei Yamada, Kentaro Matsubara, Go Oshima, Shutaro Hori, Takumi Fujimura, Ryo Takemura, Ryota Ishii, Tatsuo Kuroda, Yuko Kitagawa
(Department of Surgery, Keio University School of Medicine, Shinjuku, Japan)
Ann Transplant 2021; 26:e933774
Infectious complications after solid organ transplantation can be fatal, and early diagnosis and intervention are important. To the best of our knowledge, no study has examined the diagnostic utility of presepsin, a known accurate biomarker, for infectious complications after liver transplantation. This study aimed to evaluate the utility of presepsin for detecting infection and perioperative kinetics of presepsin after liver transplantation.
MATERIAL AND METHODS: This single-institutional prospective, observational study included 13 patients who underwent living-donor or deceased-donor liver transplantation. Perioperative serum presepsin level was measured 6 times within a week to evaluate its association with infectious complications and compare it with procalcitonin and C-reactive protein levels and leukocyte count. Postoperatively, patients were followed up for 15 days for infectious complications.
RESULTS: Five of the 13 patients developed infectious complications after liver transplantation. The median time for infection diagnosis was 9 postoperative days (25th-75th percentile, 7-10). Presepsin levels on 5 and 7 postoperative days were significantly higher in patients with infection than in those without (P=0.019 and P=0.011, respectively). In receiver operating characteristic analysis, area under the curve values of presepsin on 5 and 7 postoperative days (0.881 and 0.905, respectively) were higher than those of other biomarkers. The optimal cut-off value of presepsin was 1361 pg/mL on postoperative day 5 and 1375 pg/mL on postoperative day 7.
CONCLUSIONS: Although this study included a small number of patients, presepsin levels on postoperative days 5 and 7 may be useful indicators for infectious complications after liver transplantation.
Keywords: Bacterial Infections, C-Reactive Protein, Liver Transplantation, Presepsin Protein, Human, procalcitonin